Advanced anorexia nervosa, associated with pneumomediastinum, pneumothorax, and soft-tissue emphysema without esophageal lesion

Int J Eat Disord. 2005 Nov;38(3):281-4. doi: 10.1002/eat.20172.

Abstract

Objective: We describe the case of a 20-year-old female patient suffering from anorexia nervosa since the age 15 of years. When admitted, she was 168 cm tall with a weight of 35 kg (body mass index [BMI] = 12.4). A week after admission, the patient complained of retrosternal pain, and a few hours later she developed extensive soft-tissue emphysema.

Methods: The X-ray picture of her thorax showed left-hand supraclavicular and infraclavicular emphysema, extensive emphysema in both sides of the soft tissue of the throat, a left-hand apical pneumothorax (4 mm), and a pneumomediastinum.

Results: We discuss the extent to which these symptoms are interrelated in the sense of a causal nexus.

Conclusion: We ruled out any other differential-diagnostic etiopathogenic factors and concluded that the cause of our patient's soft-tissue emphysema, pneumothorax, and pneumomediastinum might well be autodestructive behavior.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anorexia Nervosa / complications*
  • Anorexia Nervosa / pathology
  • Disease Progression
  • Esophagus / pathology
  • Female
  • Humans
  • Mediastinal Emphysema / etiology*
  • Radiography, Thoracic
  • Retropneumoperitoneum / etiology*
  • Subcutaneous Emphysema / etiology*